Blood Bank- Ch. 16: Transfusion Therapy in Selected Patients – Flashcards
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3 systems that hemorrhage can affect
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-nervous -hormonal -circulatory
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five signs and symptoms of hemorrhagic shock
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-hypotension -tachycardia -pallor/cyanosis -cold, clammy skin -oliguria
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3 adverse effects that massive transfusion can have if blood is transfused within 3-4 hours
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-citrate toxicity -hypothermia -coagulation abnormalities
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5 priorities of massive transfusion
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-replace and maintain blood volume -optimize oxygen-carrying capacity -maintain hemostasis -correct or avoid metabolic disturbances -plasma colloid osmotic pressure
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how platelet count and function are affected during heart surgery
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-platelet count decreases (to 1/2) -platelet function affected by exposure to extracorporeal surfaces (bypass machine), hypothermia, and vasoconstriction
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age group that is most likely to receive red cell transfusions
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neonates
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difference in neonatal/pediatric transfusions
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-small size -hemoglobin changes -erythropoietin response
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3 effects that hypothermia can have on infants
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-hypoxia -hypotension -cardiac arrest
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Hgb level indicative of severe anemia in a neonate
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<13 g/dL during 1st 24 hours of life
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testing requirements for neonatal transfusion
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-ABO on chord blood -maternal Ab screen (crossmatch not necessary)
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2 tests performed to detect hemolysis in organ and tissue transplants
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-DAT -AHG crossmatch
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5 reasons to perform therapeutic apheresis
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-supply essential substance that is absent -reduce Ab levels -modify mediators of inflammation -clear immune complexes -replace cellular elements
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complications of chemotherapy
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-hematopoietic cells reduced -PLTs, WBCs, H&H levels drop
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3 causes of decreased red cell count in chronic renal disease
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-high uremic content causes abnormal RBCs removed by spleen -dialysis can shear RBCs -sufficient levels of erythropoietin are not produced
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overlapping symptoms of HUS and TTP
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-thrombocytopenia -renal dysfunction -CNS involvement -microangiopathic hemolytic anemia
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3 conditions that can lead to TTP
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-infection -pregnancy -medications
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3 conditions that can lead to HUS
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-viral infection -bacterial gastroenteritis -cytotoxic drugs
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4 negative effects of sicked red cells
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-blocked blood vessels -endothelial damage -thrombosis -pain
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3 complications of sickle cell anemia
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-stroke -acute chest syndrome -multiorgan failure
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autoimmune hemolytic anemia
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autoantibody causes red cells to be removed by the spleen
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alloimmune hemolytic anemia
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alloantibodies are produced against transfused red cells or fetal cells in HDFN
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drug-induced hemolytic anemia
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drug may be absorbed directly onto membrane or drug-antibody complex is adsorbed
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most common hemostatic disorder
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von Willebrand's disease
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3 clinical characteristics of hemostatic disorders
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-prolonged bleeding -bleeding into joints -subcutaneous bleeding
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products used for transfusion alternatives
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-factor concentrates -volume expanders -hematopoietic growth factors
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4 different volume expanders
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-crystalloids -colloids -albumin -plasma protein fraction
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hemorrhage
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rapid blood loss
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hypovolemic shock
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shock caused by low blood volume
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massive transfusion
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replacement of blood volume within 24 hours (usually 10-12 units)
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iatrogenic blood loss
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blood loss caused by treatment (including drawing blood for labs)
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therapeutic apheresis
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removal of abnormal cells, plasma, or plasma components to provide therapeutic benefits
